School Nurse, Athletic Trainer – Working Together for Students’ Health

As young professionals, many athletic trainers are taught that they should become friends with custodians and administrative assistants since these individuals can be of tremendous help. However, there may be an individual on a school campus who can help the athletic trainer even more – the school nurse.

Most people would expect that a school employs a nurse to care for the students during a school day. The National Association of School Nurses (NASN) states, however, that this may not actually be the case. In 2017, only 39 percent of American schools employ a full-time nurse while another 35 percent employ a nurse on a part-time basis. The school nurse is an integral part of the school staff, and increasing these numbers must be a greater priority for the welfare of our students.

The School Nurse

The school nurse is an allied health-care provider who may possess a few degrees and licenses in order to practice. Nurses are usually either a Licensed Practical Nurse (LPN) or a Register Nurse (RN). An LPN is an entry-level position requiring completion of an LPN education program and on-the-job training. An RN requires at least an associate’s degree, while many have at least a bachelor’s degree. Each of these individuals must be licensed by their state’s nursing board in order to practice.

A school nurse is tasked with caring for students with acute illnesses such as colds and flu, as well as chronic conditions such as asthma and diabetes. A school nurse may dispense medications within the regulations of their state and institutional policies. A school nurse will also evaluate a patient’s wellbeing by taking vital signs such as temperature, pulse and blood pressure.

The Athletic Trainer

The athletic trainer is an allied health-care provider, holding a minimum of a bachelor’s degree, a national certification and regulated by a state agency (in all states except California). The athletic trainer is trained to prevent, assess, treat and rehabilitate athletic injuries. Athletic trainers are also trained to manage emergency situations. Working in conjunction with other health-care providers, an athletic trainer works to return athletes back to their chosen sports safely. This consists of rehabilitation and preventative measures such as taping and bracing.

School Nurse + Athletic Trainer = Ultimate Student Health Team

Each of the above health-care providers bring a unique wealth of knowledge into the school setting. Through social media and conversations with other health-care providers, it appears that, in some cases, these two providers do not always work collaboratively. This failure to collaborate can create turf wars and actually may compromise students’ health and well-being.

The school nurse may feel that the employment of an athletic trainer infringes on his/her ability to be the sole health-care provider on campus. On the other hand, an athletic trainer may also find that a school nurse infringes on his/her ability to appropriately care for the student-athlete. Certainly, conflicts may occur, but it is important that these two individuals overcome these barriers and place the students’ health and well-being first and foremost.

As in any professional relationship, communication is the key. Building a cohesive student health-care team starts with the two professionals sitting down to create that relationship. Each person must work to understand the skillsets and knowledge that the other possesses and also understand where each individual may fall short.

A school nurse tends to be well-versed in what is referred to as “general medical conditions” while an athletic trainer is more well-versed in orthopedic injuries. Both individuals must be wellversed in the management of medical emergencies such as seizures and sudden cardiac arrest. Each of these individuals should be a vital component on a school-wide emergency response team and have full knowledge of how to handle common school health emergencies.

These health-care providers must understand each other’s strengths and weaknesses to better understand when each individual should be responsible for treating a particular student’s needs. Collaboration on patients throughout the day is also important. A student who may see the school nurse during second period may also go to see the athletic trainers after school. Treatments need to be in collaboration rather than contradicting each other to avoid potentially creating an accidental overdose situation in the case of medications.

Student health care continues to become an increasingly important piece of the school day. As these needs continue to grow, so does the need for collaborative care among health-care providers. School nurses and athletic trainers should work collaboratively as a student health team to provide ultimate student health care.

Mike Hopper, MS, ATC, LAT

Mike Hopper, MS, ATC, LAT is the head athletic trainer at Bishop Lynch High School in Dallas, Texas. Hopper holds a bachelor’s degree in athletic training from Southeast Missouri State University and a master’s degree in Pediatric Sports Medicine from the University of South Florida Morsani College of Medicine.